At 6 feet, 8 inches, Dr. Eeric Truumees literally stands out. “People remember who I am,” says the orthopedic surgeon in Austin, Texas. But despite height’s association with social and professional benefits, such as appearing more attractive and earning more money, towering over others has downfalls, too. “The bane of my height has been hitting my head on things,” Truumees finds, “and as I get a little slower and little less flexible, I find I’m doing that more often.” That’s just the start of height’s influence on health. Here are seven medical issues that may disproportionately affect people who are taller or shorter than average:

1. Longevity

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From an evolutionary perspective, there’s a price for enjoying the perks of being tall: a shorter lifespan. As the theory goes, “growing faster and being bigger will mean that you’ll have a shorter life, and we’ve seen that in rats,” says Mary Schooling, a professor at the City University of New York School of Public Health and Health Policy. But in humans, how the theory plays out isn’t quite clear. While certain genes have been linked to both short stature and long life, and shorter populations also seem to live longer, it’s tough to know whether stature itself influences lifespan or if characteristics like nutrition, socioeconomic status and disease risk are responsible.

2. Cancer

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If you think about what cancer is ― abnormal cells multiplying out of control ― “being taller and having a higher risk of cancer makes some sort of sense,” Schooling says, since more cells might mean more opportunity for a cancer-causing mutation. That explanation plays out in the research on hormone-related cancers, such as breast, ovarian and prostate, which are more common among the height-gifted. Growth hormone, too, may play a role in the development of cancer, since studies suggest that a lack of it lowers your risk of the disease. “That would be another possible pathway,” Schooling says.

3. Heart disease and diabetes

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Here’s one area where short people get the, well, short end of the stick: They seem to be more prone to heart disease and diabetes, research indicates. “Greater height might allow larger, more robust blood vessels,” Schooling explains. Or, perhaps taller people tend to be protected from cardiometabolic conditions because they were fed healthier diets as children or grew up in an environment where they were less exposed to infections. “We don’t know for sure if it’s really truly the height, or whether it’s something else which makes you taller and protects you against cardiovascular disease,” Schooling says.

4. Lung transplantation

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Whether in line at the deli counter or separated from friends at a concert, short people can be at a disadvantage when seeking attention. That tendency can be particularly detrimental if those folks are waiting for a lung transplant: Research suggests people 5 feet, 3 inches or shorter wait longer for the organ and are more likely to die in the process than organ recipients with more average heights. The authors suggest adjusting the transplant process – including potentially surgically “downsizing” too-big lungs – to address the disparity.

5. Injuries

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Not only are tall people more injury-prone, but their injuries are often worse than those experienced by the shorter set. “Taller patients, when they take a fall, they’re going to go a lot further and … the impact will be higher,” Truumees says, noting that older tall people have higher rates of hip fracture. Some data suggests lanky people may also be crippled by slower reactions times, he adds, since their nerve impulses have farther to travel. Professional athletes, for one, know the consequences of this phenomenon all too well: Towering players, Truumees says, tend to have higher rates of injury and take longer to recover than their littler teammates.

6. Blood clots

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Long legs: Great if you’re a model, not-so-great if you’re on a long plane ride, wearing a cast as you recover from surgery or are otherwise unable to move your leg muscles frequently to prevent blood clots, Truumees says. Indeed, one study found that men 6 feet or taller were 2.6 times more likely to develop venous thromboembolism than men at least four inches shorter; men who were both tall and obese were more than five times as likely to develop the condition. “Those people need to be very careful,” Truumees says, since, in the most severe cases, blood clots can travel to the lungs and cause death.

7. Spine, neck and back problems

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Most workspaces aren’t designed with non-average heights in mind: “Short people, tall people – they’re all working around the same cubicle or work unit, and that can cause all kinds of back and neck problems,” particularly for the tall ones, who are more prone to spine conditions like scoliosis, says Truumees, director of spine research at the Seton Spine and Scoliosis Center in Austin. While ensuring your workspace is ergonomically correct helps, some environments, like planes, can’t be altered – much to Truumees’s disappointment. “They say life is about the journey, not the destination,” he says, “but for me, it’s the destination – the journey is not all that fun.”